Lessons From Disruption: A New Normal for Families and Care Partners

Abstract COVID-19 has forced community-dwelling older adults to rely on family members and care partners more than ever before for support. Often at the expense of their own health and well-being, family members and care partners help older adults manage physical and psychosocial needs, navigate a complex, ever-changing healthcare system, and follow public health guidelines. Given the increasing demands and poor outcomes, there is no better time than now to develop policies and practices that better recognize and support family members and care partners of older adults. To inform policy and practice development, this symposium will present findings from a literature review of peer-reviewed studies published from 2019 through 2021 that identifies and addresses challenges and opportunities related to caregiving for an older adult in a pandemic. The experiences of the past year demonstrate that the new normal needs to recognize and support family members and care partners.

Consistent with the theme of the conference this year, this symposium explores the impact of the pandemic and our commitment to redress structural racism and health inequities on health of older adults, and our collective capacity to transform and innovate through our gerontological health sciences lens. Each presenter will focus on one sector of care: (1) the health system and healthcare workforce; (2) older persons; and (3) families and care partners. The first presenter provides a systems-level perspective on key disruptors in healthcare systems for care of older adults and the workforce, and emerging innovations to address increasingly transparent care inequities. Emerging research implications as a result of these disruptions will be highlighted. The second presenter highlights how the predominant features of the pandemic in older adults, loneliness and isolation, are co-occurring with significant resilience and innovation, and the resultant potential to create a paradigm shift in how we design and advance communities of care. The third presenter provides the perspective of family members and care partners of older adults during the time of the pandemic, focusing on disruptions that have informed changes going forward, innovations that have emerged, and implications for research to be addressed. Our discussant situates the presentations within the larger context of 'the new normal', with a particular focus on considering the global, inter-connected context of communities of care, a commitment to reducing inequities for older adults, and implications for health sciences education and policy.

LEVERAGING DISRUPTIONS TO CREATE AN EQUITABLE, AGE-FRIENDLY, LEARNING HEALTH SYSTEM
Eric Lenze, 1 Brian Carpenter, 2 Nancy Morrow-Howell, 2 and Beth Prusaczyk, 1 1. Washington University School of Medicine in St. Louis,Saint Louis,Missouri,United States,2. Washington University in St. Louis,Saint Louis,Missouri,United States In a learning health system, the system's own data and the experiences of its workforce are integrated with external evidence to provide better care. In an age-friendly health system, core principles of age-friendly care are integrated into every point in the system. Disruptions caused by the COVID-19 pandemic, and the innovations that addressed them, present an opportunity to discuss how these two frameworks may be combined and leveraged to transform care for older adults. We will present examples of pandemic-related disruptions, including rapid changes in how patients and providers move within and between facilities and the significant toll on healthcare workers' mental health. We will also highlight innovative solutions to these disruptions that could transform healthcare systems. Critical to these points is a discussion of how these disruptions have disproportionately impacted healthcare workers and patients of color and how the innovations must be implemented using an anti-racist, health equity lens.

INNOVATION DURING DISRUPTION: SUPPORTING WHAT MATTERS MOST TO OLDER ADULTS THROUGH PERSON-ENVIRONMENT FIT Sarah Szanton, Johns Hopkins University, Baltimore, Maryland, United States
The fragile and improvised systems of care for older adults have been decimated by isolation and fragmented care during the pandemic. However, innovations are increasingly being offered to older adults to improve the fit between them and their environment. This includes fit within the home, the social environment, the policy environment, and with clinicians. Advancing these "fits" requires evidence-based solutions like CAPABLE, a 4 month self-efficacy and function program that provides an occupational therapist, nurse and handyworker to assess and address older adults' functional goals. The older adult identifies what matters most and experiences a tailored program that taps into their purpose in life and supports engaging in meaningful activities. Starting in research sites, CAPABLE is now offered in 34 sites in 17 States and expanding through policy and insurers. Such efforts to leverage the strength of older adults and their families, builds capacity to evolve our communities of care.

LESSONS FROM DISRUPTION: A NEW NORMAL FOR FAMILIES AND CARE PARTNERS Beth Fields, University of Wisconsin-Madison, Madison, Wisconsin, United States
Innovation in Aging, 2021, Vol. 5, No. S1 COVID-19 has forced community-dwelling older adults to rely on family members and care partners more than ever before for support. Often at the expense of their own health and well-being, family members and care partners help older adults manage physical and psychosocial needs, navigate a complex, ever-changing healthcare system, and follow public health guidelines. Given the increasing demands and poor outcomes, there is no better time than now to develop policies and practices that better recognize and support family members and care partners of older adults. To inform policy and practice development, this symposium will present findings from a literature review of peer-reviewed studies published from 2019 through 2021 that identifies and addresses challenges and opportunities related to caregiving for an older adult in a pandemic. The experiences of the past year demonstrate that the new normal needs to recognize and support family members and care partners.

RE-ENVISIONING AGING IN THE RIGHT PLACE TO DISRUPT HOMELESSNESS FOR OLDER PEOPLE Chair: Rachel Weldrick Co-Chair: Sarah Canham Discussant: Joyce Weil
Recent developments in the aging-in-place literature have recognized the significance of aging-in-the-right-place. That is, aging in a place that supports an individual's unique values, vulnerabilities, and lifestyles. This symposium will build upon existing research by critically examining the potential for older persons with experiences of homelessness (OPEH) and/or housing insecurity to age-in-the-right-place. Presenters will include interdisciplinary researchers with a diversity of perspectives stemming from gerontology, social work, and environmental design. The symposium will begin with Weldrick and Canham presenting a conceptual framework for aging-in-the-right-place that has been developed to outline indicators relevant to OPEH and housing-insecure older people. Elkes and Mahmood will then discuss findings from a study of service providers working with OPEH to consider the relative benefits and challenges of temporary housing programs. Following, Brais and colleagues will present findings from an environmental audit, developed as a novel assessment tool to evaluate the accessibility and physical design of housing programs for OPEH. A final presentation by Kaushik and Walsh will highlight findings from a photovoice study on perspectives of aging-in-the-right place among OPEH during the Covid-19 pandemic. Joyce Weil, an expert in measurement of person-place fit and life course inequalities, will discuss the implications of these papers and reflect on the potential for the aging-in-the-right-place framework to address the diverse needs of the growing population of OPEH through policy and practice. Together, the participants of the symposium will advance this emerging scholarship using a wide range of methods and perspectives.

AGING IN THE RIGHT PLACE: A CONCEPTUAL FRAMEWORK FOR HOUSING INSECURE OLDER PEOPLE
Sarah Canham, 1 Atiya Mahmood, 2 Tamara Sussman, 3 Christine Walsh, 4 and Rachel Weldrick, 2 , 1. University of Utah, Salt Lake City, Utah, United States, 2. Simon Fraser University,Vancouver,British Columbia,Canada,3. McGill University,Montreal,Quebec,Canada,4. University of Calgary,Calgary,Alberta,Canada Emerging research has highlighted the significance of aging in the right place (AIRP) by recognizing that secure and optimal housing should support an individual's unique vulnerabilities and lifestyles. Existing literature, however, has yet to consider what it means for older people experiencing homelessness and/or housing insecurity to age-in-the-rightplace. In order to address this knowledge gap, a review of person-environment fit models for older people and other relevant literature was conducted to determine critical identifiers of AIRP for housing insecure older people. Findings from this literature review were then refined in collaboration with interdisciplinary scholars and community partners to establish a conceptual framework. This paper presents the resulting conceptual framework and outlines the key indicators of AIRP relevant to housing insecure older people. The proposed framework provides a practical and meaningful contribution to the literature which can be used to promote housing security among individuals often excluded from existing aging-in-place models.

AGING IN THE RIGHT PLACE? PHOTOVOICE WITH OLDER ADULTS RESIDING IN SHELTERS DURING COVID-19
Jill Hoselton Christine Walsh, and Vibha Kaushik,

University of Calgary, Calgary, Alberta, Canada
Aging in the right place (AIRP) involves supporting older adults to live as long as possible in their homes and communities, recognizing that where an older person lives impacts their ability to age optimally and must match their unique lifestyles and vulnerabilities. Photovoice, a participatory action research strategy, allows people to document their experiences through photography, promoting critical dialogue about issues such as AIRP and rights-based housing. This presentation highlights the concept of AIRP from the perspectives of a diverse group of older adults living in promising practices shelters in Vancouver, Montreal, and Calgary, Canada using photovoice. Findings indicate that the process promoted a sense of empowerment among participants. Insights about older adults' perceptions of AIRP residing in shelters to best meet their intersectional identities, housing, and support needs will be shared. Findings inform policy initiatives that promote AIRP and the right to adequate housing for older adults experiencing homelessness.

EVALUATING SPACES FOR OLDER ADULTS EXPERIENCING HOMELESSNESS: FINDINGS FROM AN ENVIRONMENTAL AUDIT
Émilie Cormier, 1 Diandra Serrano, 2 Atiya Mahmood, 3 Tamara Sussman, 2 Valérie Bourgeois-Guerin, 1 and Hannah Brais, 4 , 1. Université du Québec à Montréal, Montreal,Quebec,Canada,2. McGill University,Montreal,Quebec,Canada,3. Simon Fraser University,Vancouver,British Columbia,Canada,4. Old Brewery Mission,Old Brewery Mission,Quebec,Canada Homeless populations require spaces and services that take into account their life trajectories. The Aging in the Right Place -Environmental Checklist (AIRP-ENV) is an environmental audit tool developed by our team to evaluate the